In response to NOT-OD-09-058 (NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications), the Norris Cotton Cancer Center (NCCC) requests CCSG developmental funds to promote cancer comparative effectiveness research through targeted faculty support, pilot projects, shared resources, and technology/ methodology innovation. Dartmouth College long has been a major center for comparative effectiveness research, including the investigation of geographic variability in medical practices and pioneering studies in informed medical decision-making. The Dartmouth Atlas of Health Care is a significant research initiative of The Dartmouth Institute for Health Policy and Clinical Practice (TDI), addressing the quality of care across regions of varying health care intensity, utilizing Dartmouth's national resource for Medicare claims data. Additional relevant resources within NCCC include NCI-funded regional registries for breast cancer screening and screening colonoscopy, active trials and case-control studies in cancer prevention and cancer preventive practices, palliative care effectiveness trials, alternative breast cancer imaging program, and an active therapeutic trials program. Our specific aims are to establish a new inter-programmatic Office of Cancer Comparative Effectiveness Research (OCCER) to further develop Dartmouth CER resources, provide access and expertise for working with Medicare claims data and other major Dartmouth databases, promote application of these capabilities to currently funded cancer research through educational forums, new informatics approaches and statistical methodology development for important issues in CER. To further encourage the use of the new OCCER and to promote CER in NCCC, we will establish a pilot project program. Given the expertise of faculty within the NCCC Biostatistics Shared Resource with joint appointments in NCCC and TDI, the number of NCCC members with NCI-funded studies involving clinical outcomes, and the collaborative interest of TDI faculty with nationally recognized CER expertise, we anticipate that developmental funding will result by September 2010 in establishment of new CER collaborative efforts as a significant addition to the cancer research program at Dartmouth. RELEVANCE: We propose to extend the work of Norris Cotton Cancer Center (NCCC) by establishing a nationally recognized center of excellence in cancer comparative effectiveness research. This initiative builds on the unique strengths of NCCC and the Dartmouth Institute for Health Policy and Clinical Practice to promote research that will determine what approaches to cancer prevention, detection and treatment work best.